Active NPI
Samuel Wolf, PHARMD
- Pharmacist
- Benton, AR
National Provider Identifier
1346841517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PD14536
- Practice address
- 17309 Interstate 30 S
Benton, AR 72015-2927 - Phone
- (501) 860-6135
- NPI assigned
- Nov 4, 2020
- Last updated
- Nov 4, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PD14536 | AR | Primary |
Addresses
Primary practice location
17309 Interstate 30 S
Benton, AR 72015-2927
Mailing address
1315 River Oaks
Benton, AR 72019-1843
Phone (501) 941-9393
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PD14536 | AR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604448000000",
"number": "1346841517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1315 RIVER OAKS",
"city": "BENTON",
"state": "AR",
"postal_code": "720191843",
"telephone_number": "501-941-9393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17309 INTERSTATE 30 S",
"city": "BENTON",
"state": "AR",
"postal_code": "720152927",
"telephone_number": "501-860-6135"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLF",
"first_name": "SAMUEL",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-04",
"last_updated": "2020-11-04",
"certification_date": "2020-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "PD14536",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Benton, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.